Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Kunnskapsveien 55, 2007 Kjeller, 0130, Oslo, Norway.
Department of Nutrition and Public Health, Faculty of Health and Sport Science, University of Agder, Universitetsveien 25, 4630, Kristiansand, Norway.
Eur J Nutr. 2023 Dec;62(8):3329-3338. doi: 10.1007/s00394-023-03218-5. Epub 2023 Aug 17.
Populations following a plant-based diet may be at particular risk of thyroid dysfunction due to low iodine and selenium intakes. The main purpose was to assess thyroid function and urinary concentration of iodine, selenium, and arsenic, in subjects following a vegan, lacto-ovo vegetarian, or pescatarian diet.
In Norway, a country without mandatory dietary iodine fortification, 205 adults, following vegan (n = 115), lacto-ovo vegetarian (n = 55) and pescatarian diet (n = 35) were included. Thyroglobulin (Tg), thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), and serum anti-TPO (S-anti-TPO) were measured in a venous blood sample and concentrations of iodine (UIC), creatinine (UCC), selenium, and arsenic were measured from single spot urine samples.
Subclinical hypothyroidism (TSH > 4.0 mU/L) was observed in 3% of subjects. The overall median (p25, p75) Tg was 17 (9, 30) µg/L and vegans had higher Tg compared to pescatarians. Vegans not consuming iodine-containing supplements (n = 43) had higher Tg, than supplement users (n = 72), 27 (11, 44) vs. 16 (8, 25) µg/L and higher fT4, 16 (15, 17) vs. 15 (14, 17) pmol/L, respectively. The overall median UIC was 57 (28, 130) µg/L, all dietary groups had median UIC below WHO thresholds. Median urinary selenium and arsenic concentration was 13 (6, 22) and 3 (2, 8) µg/L, respectively.
The prevalence of subclinical hypothyroidism was low and fT4 and fT3 were within the normal range for all dietary groups. Vegans had significantly increased Tg compared to pescatarians.
由于碘和硒摄入不足，遵循植物性饮食的人群可能特别容易出现甲状腺功能障碍。本研究的主要目的是评估素食、乳蛋素食和鱼素食人群的甲状腺功能以及尿碘、硒和砷浓度。
在挪威，这个没有强制进行饮食碘强化的国家，纳入了 205 名成年人，分别为素食者（n=115）、乳蛋素食者（n=55）和鱼素食者（n=35）。采集静脉血样检测甲状腺球蛋白（Tg）、促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（fT3）、游离甲状腺素（fT4）和血清抗甲状腺过氧化物酶抗体（S-anti-TPO），并采集单次尿样检测尿碘（UIC）、肌酐（UCC）、硒和砷浓度。
3%的受试者出现亚临床甲状腺功能减退（TSH＞4.0 mU/L）。总体中位数（p25，p75）Tg 为 17（9，30）μg/L，素食者的 Tg 高于鱼素食者。未服用含碘补充剂的素食者（n=43）的 Tg 高于补充剂使用者（n=72），分别为 27（11，44）μg/L和 16（8，25）μg/L，fT4 也更高，分别为 16（15，17）pmol/L 和 15（14，17）pmol/L。总体中位数 UIC 为 57（28，130）μg/L，所有饮食组的 UIC 中位数均低于世卫组织阈值。中位数尿硒和砷浓度分别为 13（6，22）μg/L 和 3（2，8）μg/L。
所有饮食组的亚临床甲状腺功能减退患病率均较低，fT4 和 fT3 均在正常范围内。素食者的 Tg 明显高于鱼素食者。
